Development and validation of a structured questionnaire to assess screen exposure, influence of food advertisement and parental nutrition knowledge in early childhood

Nagadharshini P.; Veena B. M.; Shweatha H. E.; Meena Kumari

doi:10.18203/2394-6040.ijcmph20262695

Authors

Nagadharshini P. Department of Nutrition and Dietetics, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
Veena B. M. Department of Nutrition and Dietetics, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
Shweatha H. E. Department of Nutrition and Dietetics, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
Meena Kumari Department of Food technology, Amity University, Noida, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20262695

Keywords:

Validation, South India, Screen time, Reliability, Questionnaire development, Preschoolers, Dietary behaviour, Food advertising, Parental nutrition knowledge

Abstract

Background: Early childhood is a critical period for the establishment of food preferences and eating behaviour. The growing penetration of digital media and targeted food advertising has increased children’s exposure to energy-dense, nutrient-poor products, while parental nutrition knowledge mediates the impact of these exposures on child dietary behaviour.

Methods: This cross-sectional, questionnaire-based instrument development and validation study was conducted among parent-child dyads recruited from Anganwadi centres and private preschools in Mysuru and Hosur taluks between March 2024 and October 2025. A structured questionnaire covering four domains food advertising exposure, screen-time patterns, parental nutrition knowledge, and preschoolers’ eating habits- was developed through item generation, expert content/face validation (content validity ratio using Lawshe’s method), pilot testing (n=25), and reliability testing, before administration to the final study sample of 1200 parent-child dyads (600 each from Mysuru and Hosur).

Results: The questionnaire demonstrated good overall internal consistency (Cronbach’s α=0.78), with domain-wise values of 0.83 (food advertising exposure), 0.76 (screen time patterns), 0.72 (parental nutrition knowledge), and 0.81 (preschoolers’ eating habits). Among the 1200 children (mean age distributed across 3-5 years; 54.3% boys in Mysuru and 50.8% girls in Hosur), average daily screen time was 1.39±0.74 hours, with 23.3% of children in the high (>2 hours/day) screen-time category. Socio-economic classification using the Modified Kuppuswamy Scale (2025) showed the largest proportion of families (40.0%) in the lower-middle class, and 37.3% of parents demonstrated low nutrition knowledge at baseline.

Conclusions: The developed questionnaire is a valid and reliable instrument for the integrated assessment of food advertising exposure, screen-time behaviour, parental nutrition knowledge, and dietary habits among preschool-aged children, and offers a practical, replicable tool for researchers and public health practitioners.

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